| NPI | 1982766549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS JANE MOORE Np 650-742-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CA 193145) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |